Her Real Family Christmas

‘No.’

‘OK. Do you ever notice that Mia’s a bit short of breath or her nostrils flare?’

Daniel realised swiftly that Stephanie was running through a list of asthma symptoms. ‘No. Is that what you think it is? Asthma?’

‘It’s quite a strong possibility,’ she said.

He shook his head. ‘Mia just has a cold. They always go to her chest and she ends up with a bad cough—she had bronchiolitis when she was tiny and she was in here for a week on oxygen.’

Stephanie nodded. ‘Colds are often worse for little ones after they’ve had RSV. And I guess seeing her here on oxygen is reminding you of that? It’s tough.’

‘Yes,’ he admitted. It brought back all the nights when he and Meg had taken turns to sit at their tiny baby’s bedside, feeding her through a nasogastric tube because the virus had left Mia too exhausted to drink normally. ‘I guess I panicked a bit.’

‘No, you did exactly the right thing, bringing her in,’ Stephanie reassured him. ‘She wasn’t getting as much oxygen as I’d like, so the medication’s going to help a lot. Though I’d also like to admit her overnight and keep an eye on her. So she’s had a cold recently?’

‘For three or four days. And yesterday it went to that croupy cough.’ He sighed. ‘Usually a steamy bathroom helps. I get her to drink warm blackcurrant or something like that, and keep her sitting upright on my lap.’

‘Which are all exactly the right things to do to treat a cough,’ Stephanie said. ‘Colds are viral infections, Mr Connor, so antibiotics won’t do anything to help and I won’t prescribe them, but liquid paracetamol will help to keep Mia’s temperature down.’

Daniel thought about telling Stephanie that he was a doctor and he was well aware of the problems with antibiotic resistance, but that wouldn’t help Mia—and his daughter was a lot more important than his professional pride. ‘I last gave her some of that about four hours ago, so she’s due some more now anyway,’ he said. ‘The steamy bathroom didn’t work this time.’

‘Does she get many coughs like this?’

‘Too many,’ he admitted. ‘She hates having time off school when this happens, but she gets so tired and the cough just won’t stop.’

Stephanie looked thoughtful. ‘Has your family doctor prescribed corticosteroids for her?’

‘No.’

‘It’s usually a treatment for asthma, but it’s also very good for reducing inflammation in airways when children have this sort of virus. And I should explain that corticosteroids are the same kind of steroids that the body produces naturally, not the sort you associate with bodybuilders.’

Yes, it was way, way too late now to tell Stephanie Scott that he was a doctor; it would just embarrass them both. But Daniel liked the clear way she explained things. It was a pity she was on the emergency department team, as he had a feeling that she’d be good with neonates. Unless she was a locum, maybe? He’d check that when he was back on duty and, if she was a locum, he’d get Theo to add Stephanie to their list. She’d be a real asset to their team.

Mia’s breathing started to ease as the medication did its job. Stephanie glanced at the readout on the oximeter. ‘I’m happier now. She’s responding nicely. Mia, I’d like you to stay here tonight just so we can make sure that cough’s getting better or give you more of the special medicine if it doesn’t. Daddy can stay with you if he wants to—’ she looked at him ‘—or maybe Mia’s mum might like to stay with her?’

Daniel was pretty sure that Mia’s mum would be there in spirit; but, oh, how he wished she could be there in body, too. He’d had four years now of being a single parent, and it didn’t get any easier. Missing Meg hadn’t got much easier, either. Though, between them, Mia and his work kept him too busy to focus on how lonely he felt. He had to swallow the sudden lump in his throat. ‘I’ll stay with her,’ he said gruffly.

Stephanie took him up to the children’s ward, settled Mia in and made sure that Daniel was comfortable, then sorted out the paperwork. ‘I’ll see you both tomorrow before the end of my shift,’ she said. ‘If you need anything, just go and have a word with the nurse. If it’s an emergency, then you press that button there and someone will be straight with you.’

He already knew all that. But he appreciated the way she was looking after them and it would be churlish to say anything. ‘Thank you.’

‘No worries.’ She squeezed Mia’s hand. ‘You try to get some rest, sweetheart, OK?’

The little girl nodded tiredly.

‘I’ll see you later.’

Stephanie was almost tempted to call in and see the Connors on her break. Mia’s father had looked so tired and worried. And it was unusual for a dad to be at the hospital with a child on his own; in her experience, mothers usually took over when a child was ill. Unless maybe Mia’s mum wasn’t well herself, or had been working a night shift. Or, given the way Mr Connor had flinched when she’d mentioned Mia’s mum, maybe he was a single dad and he was worried about the fact his daughter had become ill so quickly when he was looking after her.

No. She needed to keep some professional distance. Besides, she knew better than to get involved—especially given the way her world had imploded the last time she’d got involved with someone else’s medical problems. It had put her marriage on its final crash-and-burn trajectory; although it had been four years now since the divorce, it still hurt to think about the way things had gone so badly wrong. The way all her dreams had blown up in her face. The way she’d managed to lose a second family. And all because she’d put her job first.

Now her job was all she had. And that had to be enough.

She shook herself. Enough of the self-pity. She needed to concentrate on what she was supposed to be doing: working the night shift on the paediatric assessment unit. Though her shift was reasonably quiet, and that gave her time to research her hunch on Mia Connor’s condition.

When she’d done the handover at the end of her shift, she called up to the children’s ward to see how Mia was getting on.

Mia’s dad looked as if he’d barely slept and, although Mia was sleeping, the little girl was still coughing in her sleep.

‘Hi,’ he said, giving Stephanie a tired smile.

‘Rough night?’ she asked sympathetically.

He nodded. ‘But I’m glad I could be here for her.’

‘I’ve been thinking about Mia. Given that you don’t have a family history of asthma, I think she has reactive airways. Whenever anyone gets a cold, their airways tend to get a bit swollen, but if someone has reactive airways their systems really overreact.’ She drew a swift diagram on a piece of paper.

‘Basically, these are Mia’s lungs. They work a bit like a tree, with her windpipe as the trunk and the smaller airways like branches. The airways are covered in muscle—a bit like the bark of a tree—and inside they have mucous membranes, which produce mucus to keep the lungs clean. When she gets a cold, her muscles tighten and the mucous membranes swell and produce more mucus than usual. That makes her airways narrow, which in turn makes it harder for her to breathe.’

She glanced at him to check that he was following what she’d said; it was the clearest way she could explain things, but he obviously hadn’t slept much overnight in the chair next to his daughter’s bed and she wasn’t sure how much of this he was taking in.

‘Reactive airways.’ He looked thoughtful. ‘So can you give her something for it?’

‘Yes. Corticosteroids, an inhaler and a nebuliser. I’ll write the prescription, but as Mia’s asleep at the moment I don’t want to wake her. One of my colleagues will show you how to use them when she does wake. The corticosteroids will stop the swelling in her throat, so if you get her to use the inhaler and nebuliser as soon as you spot the symptoms, hopefully she won’t end up with that really croupy cough next time.’

‘Thank you.’

‘Though there are sometimes side effects,’ Stephanie warned. ‘She might have a headache or an upset tummy, or be sick. If that’s the case, your family doctor can review the treatment and prescribe a slightly different medication, but this one should do the trick.’

‘I appreciate that.’ He raked a hand through his hair. ‘And thank you for being so reassuring last night. You were really good with Mia.’

His praise warmed her—and that was dangerous. She never let herself react like this to anyone. She was good at her job and she did what needed to be done; but she didn’t allow anyone too close, patient or colleague. She’d learned after Joe that she was better off on her own. Nobody to get her hopes up, and nobody to let her down.

She shrugged off his praise and gave him a small smile. ‘No worries. It’s what I’m supposed to do.’ She wrote on Mia’s chart. ‘Do you have any questions, or is there anything you’re not clear about with her condition and the treatment?’

‘No, it’s all fine. Thanks.’

‘OK. Well, good luck.’ She shook his hand, and left the department.

Four days later, Stephanie was called in to the maternity department to check over a baby after an emergency Caesarean section.

The obstetric surgeon was still in the middle of the operation, so Stephanie introduced herself to the midwife and the registrar and waited for the baby to be delivered.

‘So what’s the history?’ she asked.

‘The mum had pre-eclampsia—it came on really suddenly,’ the midwife explained. ‘She was fine at her last check-up; her blood pressure was a bit high, but she’d been rushing around all day. And then today she started feeling really rough, had a headache she couldn’t shift and swollen ankles. Her community midwife sent her in to us, and her blood pressure had spiked and there was protein in her urine. Daniel wasn’t happy with the baby’s heartbeat and so he brought her straight up here.’

Daniel, Stephanie presumed, was the surgeon. She knew that the only cure for pre-eclampsia was to deliver the baby. ‘How many weeks is she?’ she asked.